The accepted treatment for Gynecomastia is Lipo-Excision; which is a combination of liposuction and excision (removal) of the gland.
Liposuction alone cannot treat gynecomastia as the main issue in gynecomastia is the breast tissue and not the fat.
However, many men who come to me ask if liposuction is necessary for all gynecomastia along with excision of the gland.
Ever since the combination of liposuction and excision of glands came to the forefront for treating gynecomastia, it has been used in all but very skinny or very muscular patients. Such patients, though uncommon, are not rare. In such individuals, there may not be enough fat that needs removing. A simple excision (complete or near-complete) would suffice. Such cases may occasionally be tricky in terms of the extent of gland removal. While complete removal is theoretically safe, it does lead to a subtle crater deformity. There is an argument for leaving a very thin sliver of gland behind in most people. Also, the merits of subtle liposuction to smoothen out the edges cannot be overstated.
The expertise of a surgeon will, in most cases, determine the outcome. It is more challenging to treat such individuals than normally built men.
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